A recent study published in the journal Cancer reveals that higher levels of pain in cancer survivors are linked to increased use of tobacco and cannabis. Specifically, the research found that individuals experiencing more intense pain were more likely to smoke cigarettes and e-cigarettes, as well as use cannabis within the last 30 days.
Chronic pain is a frequent issue for cancer survivors, with estimates indicating that about one-third of these patients suffer from pain lasting three months or longer. While previous studies have shown a connection between pain and nonopioid substance use in the general population, this relationship had not been thoroughly examined among cancer survivors.
Jessica M. Powers, PhD, from Northwestern University Feinberg School of Medicine in Chicago, Illinois, and her team utilized two national datasets to explore this issue. The first dataset, Wave 6 of the Population Assessment of Tobacco and Health Study, included 1,252 adult patients with a self-reported history of cancer, collected between March and November 2021. Of these participants, around 31% reported currently having cancer, while 69% were in remission.
In their findings, the researchers noted that higher pain intensity in the past week was correlated with greater odds of cigarette and e-cigarette use. Additionally, they found that pain was associated with a heightened risk of cannabis use over the past month. Interestingly, while both past-week pain intensity and cigarette smoking were linked to increased fatigue and poorer overall health, higher pain levels were associated with lower alcohol consumption over the previous 30 days.
Dr. Powers emphasized the importance of creating targeted substance cessation interventions for cancer survivors dealing with chronic pain, noting the need for integrated approaches that address both smoking and pain management.
The second dataset used in the study was the 2020 National Health Interview Survey, which involved 4,130 adult patients with a self-reported history of cancer. Results from this survey indicated that cancer survivors suffering from chronic pain were more likely to use cigarettes and e-cigarettes, while their chronic pain was associated with a lower likelihood of consuming alcohol in the preceding year.
Furthermore, the study revealed that both chronic pain and cigarette smoking were independently linked to higher levels of fatigue, as well as difficulties in sleeping. Cancer survivors facing chronic pain and cigarette use also exhibited increased levels of anxiety and depression, along with a lower perception of their overall health.
Dr. Powers and her colleagues reiterated the need for tailored interventions to help cancer survivors manage substance use related to pain. They pointed out that while preliminary research has looked into combining smoking cessation with pain management for cancer survivors, there has been limited exploration of targeted interventions for cannabis and alcohol use in this population.
This research received support from the National Institute on Aging, the National Cancer Institute, and the National Center for Advancing Translational Sciences. For a complete list of disclosures, please refer to the original study.
